when insurance doesn't cover
Question from just wondering on 11/24/2012:

Can cost be a morally acceptable factor for a family to decide to remove someone from a ventilator? If the patient doesn't have enough insurance and the spouse or parent would have to sell their home or give all their retirement savings to continue a ventilator, is it morally acceptable for the family to allow the stopping of the ventilator? Should families give all they have or can this make the situation extraordinary care?

Answer by Judie Brown on 11/28/2012:

Dear Just Wondering

While you are painting a worse case scenario, the fundamental answer to your question is
found in the Vatican document on euthanasia, where ordinary versus extraordinary care is
defined.
http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_198
00505_euthanasia_en.html

I quote:

"... it will be possible to make a correct judgment as to the means by studying the type of
treatment to be used, its degree of complexity or risk, its cost and the possibilities of using it,
and comparing these elements with the result that can be expected, taking into account the
state of the sick person and his or her physical and moral resources. In order to facilitate the
application of these general principles, the following clarifications can be added: - If there are
no other sufficient remedies, it is permitted, with the patient's consent, to have recourse to
the means provided by the most advanced medical techniques, even if these means are still at
the experimental stage and are not without a certain risk. By accepting them, the patient can
even show generosity in the service of humanity. - It is also permitted, with the patient's
consent, to interrupt these means, where the results fall short of expectations. But for such a
decision to be made, account will have to be taken of the reasonable wishes of the patient and
the patient's family, as also of the advice of the doctors who are specially competent in the
matter. The latter may in particular judge that the investment in instruments and personnel is
disproportionate to the results foreseen; they may also judge that the techniques applied
impose on the patient strain or suffering out of proportion with the benefits which he or she
may gain from such techniques. - It is also permissible to make do with the normal means
that medicine can offer. Therefore one cannot impose on anyone the obligation to have
recourse to a technique which is already in use but which carries a risk or is burdensome.
Such a refusal is not the equivalent of suicide; on the contrary, it should be considered as an
acceptance of the human condition, or a wish to avoid the application of a medical procedure
disproportionate to the results that can be expected, or a desire not to impose excessive
expense on the family or the community. - When inevitable death is imminent in spite of the
means used, it is permitted in conscience to take the decision to refuse forms of treatment
that would only secure a precarious and burdensome prolongation of life, so long as the
normal care due to the sick person in similar cases is not interrupted. In such circumstances
the doctor has no reason to reproach himself with failing to help the person in danger.